Global & Disaster Medicine

Archive for the ‘Famine’ Category

“……And in the hushed hunger wards, ailing infants hover between life and death. Of nearly two million malnourished children in Yemen, 400,000 are considered critically ill — a figure projected to rise by one quarter in the coming months...….”

“……..Even during harvest time in January, when food was most abundant, more than five million people — almost half the population — did not have enough to eat. Now, as food runs out over the next few months, international officials expect that number to grow considerably, with millions potentially facing acute malnutrition.……”

WHO and Federal Ministry of Health of Somalia call for urgent support to address measles outbreak in Somalia

16 August 2017 – As millions of people in Somalia remain trapped in a devastating cycle of hunger and disease, WHO and health partners are working with national health authorities to save lives and reach the most vulnerable with essential health services.

More than 2 years of insufficient rainfall and poor harvests have led to drought, food insecurity and a real risk of famine. Malnutrition, mass displacement as a result of the drought, and lack of access to clean water and sanitation have created ideal conditions for infectious disease outbreaks.

“Somalia is facing one of the worst humanitarian crises in the world. Millions of people, already on the brink of famine, are now at risk of rapidly spreading infectious diseases like cholera and measles. Normally, these diseases are easy to treat and prevent, but they can turn deadly when people are living in overcrowded spaces and are too weak to fight off infection,” said Dr Ghulam Popal, WHO Representative in Somalia.

Drought has led to a lack of clean water and the largest cholera outbreak in the last 5 years, with more than 57 000 cases and 809 cumulative deaths reported as of 31 July 2017. Health partners, together with national health authorities, scaled up its efforts to respond to this event by setting up cholera treatment centers in affected districts and providing support in water and sanitation to prevent the spread of the disease. In March, WHO and partners conducted Somalia’s first national oral cholera vaccination campaign, and successfully reached over 450 000 vulnerable people. Due to ongoing efforts, the number of cholera cases in Somalia has declined, from 13 656 cases of acute watery diarrhoea/cholera in May 2017 to 11 228 cases in June 2017.

Somalia is also facing its worst measles outbreak in 4 years, with over 14 823 suspected cases reported in 2017 (as of 31 July), compared to 5000–10 000 cases per year since 2014. The situation is especially critical for millions of under-vaccinated, weak and hungry children who are more susceptible to contracting infectious diseases. More than 80% of those affected by the current outbreak are children under 10 year of age.

In early 2017, WHO and partners, in collaboration with national health authorities, vaccinated almost 600 000 children aged 6 months to 5 years for measles in hard-to-reach and hotspot areas across the country. Despite these efforts, the transmission of measles continues, compounded by the ongoing pre-famine situation, continued mass displacement, and undernourished children living in unhygienic conditions.

In order to contain the outbreak, a nationwide campaign is planned for November 2017 to stop transmission of the disease, targeting 4.2 million children. The campaign will also intensify efforts to strengthen routine immunization and reach unvaccinated children to boost their immunity. As shown by the response to the cholera outbreak, with the right interventions, health authorities are confident that similar success may be seen in controlling the measles outbreak.

US$ 14.4 million (a cost of US$ 3.36 per child) is required by WHO and health partners to conduct the measles vaccination campaign in November 2017, of which WHO required US$ 6.8 million. To date, no funding has been received.

“…..In March, a reportfrom the U.N.’s Office for the Coordination of Humanitarian Affairs (OCHA) estimated that of the 2.1 million Haitians affected by the hurricane last October, 1.4 million still don’t have enough food or safe drinking water.

The humanitarian context in Haiti remains challenging as the country continue to be affected by a convergence of humanitarian crises further aggravated by Hurricane Matthew and which has severely impacted the pre-existing humanitarian situation. Despite immediate humanitarian response provided so far, post Hurricane Matthew’s humanitarian needs are still high with an estimated 1.4 million people in need of humanitarian assistance. Additionally, 1.5 million vulnerable Haitians are currently food insecure and 280 K highly food insecure and in need of urgent food assistance. Cholera and the bi-national crisis continue also to be humanitarian threats to the country with respectively 1,856 cholera cases reported in January 2017 and 175,578 returnees registered from the Dominican Republic as of 2 March 2017.

11 May 2017 | GENEVA – WHO is concerned by the chronic shortage of funding for life-saving work in Somalia in response to the ongoing drought that has plunged the country further towards famine, disease, and health insecurity. Drought in Somalia led to the destruction of crops and livestock, leaving more than 3.3 million people hungry every day. If the current situation continues, famine could soon be a reality, creating a devastating cycle of hunger and disease as the health of people deteriorates and they become more susceptible to infection. Drought has also led to lack of clean water and the largest outbreak of cholera Somalia has seen in the last 5 years, with more than 36 000 cases and almost 690 deaths so far in 2017 alone. With the beginning of the expected rainy season and floods this month, these numbers are expected to increase to 50 000 cases by the end of June. Cases of measles are also on the rise, with nearly 6 500 cases reported this year, 71% of them children under the age of 5 years.

“History has shown the terrible consequences of inaction, or action that comes too late. More than a quarter of a million lives – half of them children – were lost as a result of the devastating famine of 2011. This year, a much larger percentage of the population is now at risk. We will not stand by and watch millions of already vulnerable men, women, and children become victims of an avoidable catastrophe,” said Dr. Peter Salama, WHO Executive Director for Emergencies.

WHO commends the Government of the United Kingdom for its leadership in hosting an international conference today to tackle the country’s most urgent challenges, and calls on the international community to take decisive action to help avoid a humanitarian catastrophe. So far in 2017, health sector requirements of US$ 103 million are only 23% funded and WHO has received less than 10% of US$ 25 million required for an organizational response. WHO urgently appeals for additional support from the international community to ensure the health response can continue and expand, to save lives and alleviate the suffering of millions of Somalis.

Background

Whilst the operating environment in Somalia remains challenging, and humanitarian access restricted as a result of ongoing conflict and violence in many parts of the country, WHO and health partners continue to scale up their response, with coordination hubs established in Mogadishu, Garowe, Hargeisa and Baidoa. In March and April 2017, WHO delivered nearly 50 tons of medicines and medical supplies to provide life-saving support for almost 4.3 million people. Cholera treatment centres are now operational in 40 districts, and the numbers of surveillance sites for epidemic-prone diseases have been increased across the country, with Rapid Response Teams deployed to support investigation and response activities. In March, WHO and partners conducted the first national oral cholera vaccination campaign in Somalia, reaching over 450 000 vulnerable people. A second campaign is ongoing in South West State and Middle Shebelle, targeting 463 000 vulnerable people.

10 March 2017 – Just back from Kenya, Yemen, South Sudan and Somalia – countries that are facing or are at risk of famine – the top United Nations humanitarian official today urged the international community for comprehensive action to save people from simply “starving to death.”

“We stand at a critical point in history. Already at the beginning of the year we are facing the largest humanitarian crisis since the creation of the UN,” UN Emergency Relief Coordinator Stephen O’Brien told the Security Council today.

Without collective and coordinated global efforts, he warned, people risk starving to death and succumbing to disease, stunted children and lost futures, and mass displacements and reversed development gains.

“The appeal for action by the Secretary-General can thus not be understated. It was right to sound the alarm early, not wait for the pictures of emaciated dying children […] to mobilize a reaction and the funds,” Mr. O’Brien underscored, calling for accelerated global efforts to support UN humanitarian action on the ground.

Turning to the countries he visited, the senior UN official said that, about two-thirds of the population (more than 18 million people) in Yemen needed assistance, including more than seven million severely food insecure, and the fighting continued to worsen the crisis.

“I continue to reiterate the same message to all: only a political solution will ultimately end human suffering and bring stability to the region,” he said, noting that with access and funding, humanitarians will do more, but cautioned that relief-workers were “not the long-term solution to the growing crisis.”

In South Sudan, where a famine was recently declared, more than 7.5 million people are in need of assistance, including some 3.4 million displaced. The figure rose by 1.4 million since last year.

“The famine in the country is man-made. Parties to the conflict are parties to the famine – as are those not intervening to make the violence stop,” stressed Mr. O’Brien, calling on the South Sudanese authorities to translate their assurances of unconditional access into “action on the ground.”

Similarly, more than half the population of Somalia (6.2 million people) is need aid, 2.9 million of whom require immediate assistance. Extremely worrying is that more than one million children under the age of five are at the risk of acute malnourishment.

“The current indicators mirror the tragic picture of 2011, when Somalia last suffered a famine,” recalled the UN official, but expressed hope that a famine can be averted with strong national leadership and immediate and concerted support by the international community.

Concerning Kenya, he mentioned that more than 2.7 million people were food insecure, and that this number could reach four million by April.

“In collaboration with the Government [of Kenya], the UN will soon launch an appeal of $200 million to provide timely life-saving assistance and protection,” he informed.

Further in his briefing, Mr. O’Brien informed the Council of the outcomes of the Oslo Conference on the Lake Chad Basin where 14 donors pledged a total of $672 million, of which $458 million is for humanitarian action in 2017.

“This is very good news, and I commend those who made such generous pledges,” he said but noted that more was needed to fully fund the $1.5 billion required to provide the assistance needed across the region.

On the UN response in these locations, Mr. O’Brien highlighted that strategic, coordinated and prioritized plans are in place and dedicated teams on the ground are closely working with partners to ensure that immediate life-saving support reaches those in need.

“Now we need the international community and this Council to act,” he highlighted, urging prompt action to tackle the factors causing famine; committing sufficient and timely financial support; and ensuring that fighting stops.

In particular, he underscored the need to ensure that humanitarians have safe, full and unimpeded access and that parties to the conflict in the affected countries respect humanitarian lawand called on those with influence over the parties to the conflict to “exert that influence now.”

“It is possible to avert this crisis, to avert these famines, to avert these looming human catastrophes,” he concluded. “It is all preventable.”

UN agencies warn that almost 5 million people urgently need food, agriculture and nutrition assistance

JUBA – War and a collapsing economy have left some 100,000 people facing starvation in parts of South Sudan where famine was declared today, three UN agencies warned. A further 1 million people are classified as being on the brink of famine.

The Food and Agriculture Organization of the United Nations (FAO), the United Nations Children’s Fund (UNICEF) and the World Food Programme (WFP) also warned that urgent action is needed to prevent more people from dying of hunger. If sustained and adequate assistance is delivered urgently, the hunger situation can be improved in the coming months and further suffering mitigated.

The total number of food insecure people is expected to rise to 5.5 million at the height of the lean season in July if nothing is done to curb the severity and spread of the food crisis.

According to the Integrated Food Security Phase Classification (IPC) update released today by the government, the three agencies and other humanitarian partners, 4.9 million people – more than 40 percent of South Sudan’s population – are in need of urgent food, agriculture and nutrition assistance.

Unimpeded humanitarian access to everyone facing famine, or at risk of famine, is urgently needed to reverse the escalating catastrophe, the UN agencies urged. Further spread of famine can only be prevented if humanitarian assistance is scaled up and reaches the most vulnerable.

Famine is currently affecting parts of Unity State in the northern-central part of the country. A formal famine declaration means people have already started dying of hunger. The situation is the worst hunger catastrophe since fighting erupted more than three years ago.

“Famine has become a tragic reality in parts of South Sudan and our worst fears have been realised. Many families have exhausted every means they have to survive,” said FAO Representative in South Sudan Serge Tissot. “The people are predominantly farmers and war has disrupted agriculture. They’ve lost their livestock, even their farming tools. For months there has been a total reliance on whatever plants they can find and fish they can catch.”

Malnutrition is a major public health emergency, exacerbated by the widespread fighting, displacement, poor access to health services and low coverage of sanitation facilities. The IPC report estimates that 14 of the 23 assessed counties have global acute malnutrition (GAM) at or above the emergency threshold of 15 percent, with some areas as high as 42 percent.

“More than one million children are currently estimated to be acutely malnourished across South Sudan; over a quarter of a million children are already severely malnourished. If we do not reach these children with urgent aid many of them will die,” said Jeremy Hopkins, UNICEF Representative a.i in South Sudan. “We urge all parties to allow humanitarian organizations unrestricted access to the affected populations, so we can assist the most vulnerable and prevent yet another humanitarian catastrophe.”

“This famine is man-made. WFP and the entire humanitarian community have been trying with all our might to avoid this catastrophe, mounting a humanitarian response of a scale that quite frankly would have seemed impossible three years ago. But we have also warned that there is only so much that humanitarian assistance can achieve in the absence of meaningful peace and security, both for relief workers and the crisis-affected people they serve,” said WFP Country Director Joyce Luma. “We will continue doing everything we possibly can to hold off and reverse the spread of famine.”

Across the country, three years of conflict have severely undermined crop production and rural livelihoods. The upsurge in violence since July 2016 has further devastated food production, including in previously stable areas. Soaring inflation – up to 800 percent year-on-year – and market failure have also hit areas that traditionally rely on markets to meet food needs. Urban populations are also struggling to cope with massive price rises on basic food items.

FAO, UNICEF and WFP, with other partners, have conducted massive relief operations since the conflict began, and intensified those efforts throughout 2016 to mitigate the worst effects of the humanitarian crisis. In Northern Bahr El Ghazal state, among others, the IPC assessment team found that humanitarian relief had lessened the risk of famine there.

FAO has provided emergency livelihood kits to more than 2.3 million people to help them fish or plant vegetables. FAO has also vaccinated more than 6 million livestock such as goats and sheep to prevent further loss.

WFP continues to scale up its support in South Sudan as humanitarian needs increase, and plans to provide food and nutrition assistance to 4.1 million people through the hunger season in South Sudan this year. This includes lifesaving emergency food, cash and nutrition assistance for people displaced and affected by conflict, as well as community-based recovery or resilience programs and school meals.

In 2016, WFP reached a record 4 million people in South Sudan with food assistance — including cash assistance amounting to US$13.8 million, and more than 265,000 metric tons of food and nutrition supplies. It is the largest number of people assisted by WFP in South Sudan since independence, despite problems resulting from the challenging context.

UNICEF aims to treat 207,000 children for severe acute malnutrition in 2017. Working with over 40 partners and in close collaboration with WFP, UNICEF is supporting 620 outpatient therapeutic programme sites and about 50 inpatient therapeutic sites across the country to provide children with urgently needed treatment. Through a rapid response mechanism carried out jointly with WFP, UNICEF continues to reach communities in the most remote locations. These rapid response missions treat thousands of children for malnutrition as well as provide them with immunization services, safe water and sanitation which also prevents recurring malnutrition.

Republic of South Sudan: Current and Projected (January-July 2017) Acute Food Insecurity Situation

01/01/2017 – 31/07/2017

South Sudan

Extreme levels of food insecurity and localized famine conditions

According to the IPC Analysis update conducted by the South Sudan IPC Technical Working Group (TWG) and endorsed by the government:

The food security situation in South Sudan continues to deteriorate, with 4.9 million (about 42% of population) estimated to be severely food insecure (IPC Phases 3, 4, and 5), from February to April 2017. This is projected to increase to 5.5 million people, (47% of the national population) at the height of the 2017 lean season in July. The magnitude of these food insecure populations is unprecedented across all periods.

In Greater Unity, some counties are classified in Famine or high likelihood/risk of Famine. In the absence of full quantitative data sets (food consumption, livelihoods changes, nutrition and mortality), analyses were complemented with professional judgment of the Global IPC Emergency Review Committee and South Sudan IPC Technical Working Group (SS IPC TWG) members. The available data are consistent with Phase 5 (Famine) classification and include available humanitarian assistance plans at the time of the analysis. In January 2017, Leer County was classified in Famine, Koch at elevated likelihood that Famine was happening and Mayendit had avoided Famine through delivery of humanitarian assistance. From February to July 2017, Leer and Mayendit are classified in Famine, while Koch is classified as Famine likely to happen. Panyijiar was in Phase 4 (Emergency) in January and is likely to avoid a Famine if the humanitarian assistance is delivered as planned from February to July 2017. With consistent, adequate, and timely humanitarian interventions, the Famine classification could be reversed with many lives saved.

Acute malnutrition remains a major public health emergency in South Sudan. Out of 23 counties with recent data, 14 have Global Acute Malnutrition (GAM) at or above 15%. GAM of above 30% is observed in Leer and Panyijiar while Mayendit had GAM levels of 27.3%. Similarly, a worsening nutrition situation atypical to the post-harvest season is observed in the Greater Equatoria region – particularly in Greater Central Equatoria – a deterioration associated with widespread insecurity, lack of physical access, disruption of the 2016 agricultural season and the ongoing economic crisis. Areas in the Greater Bahr el Ghazal show higher than usual levels of acute malnutrition expected for the post-harvest season, indicating a worsening situation. Insecurity, displacement, poor access to services, extremely poor diet (in terms of both quality and quantity), low coverage of sanitation facilities and deplorable hygiene practices are underlying the high levels of acute malnutrition.

Humanitarian assistance throughout 2016 not only sustained but also improved food security in many areas.It is of paramount importance that assistance not only continues in 2017, but scales up in the face of mounting food insecurity across the country. The expected response to Famine-affected areas in former Unity must not sacrifice much needed assistance to the other severely food insecure areas of the country. There exists a narrow window of opportunity during the dry season to pre-position and deliver humanitarian assistance to prevent drastic increases in food insecurity through the lean season that peaks in July. The overstretching of current humanitarian resources and capabilities during the projected worsening of food insecurity is a distinct possibility, raising the risk of an insufficient response to further deterioration.

Humanitarian access remains a major challenge in implementing lifesaving interventions and critical assessments of the situation in the worst affected areas. It is imperative that unconditional humanitarian access from all parties involved in the ongoing political conflict is granted to facilitate delivery of assistance to the populations in need. The most food insecure areas show high levels of insecurity, displacement, loss of livelihoods, market failure, and constrained humanitarian access for assistance delivery and monitoring. The key areas to monitor are central and southern Greater Unity, Greater Northern Bahr el Ghazal, drought-affected Greater Pibor and Greater counties of Kapoeta, Malakal, Fashoda, Manyo, Nasir, Kajo-Keji, Yei, Morobo, and Lainya.